Journal of Urology最新文献

{"title":"Reply by Authors.","authors":"Jiwei Huang, Xingyun Cai, Cheoklong Ng, Yuansheng Luo, Qiong Chen, Zaoyu Wang, Keying Qiao, Wen Kong, Jin Zhang, Yonghui Chen, Wei Zhang, Jiyang Zhang, Dadong Zhang, Guangyu Wu, Haige Chen, Wei Xue","doi":"10.1097/JU.0000000000004510","DOIUrl":"10.1097/JU.0000000000004510","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"751"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625117","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Factors Associated With Urinary Incontinence in Nulliparous Female Elite Athletes: An Exploratory, Cross-Sectional Study Using Dynamic Pelvic Magnetic Resonance Imaging and Questionnaire Data.","authors":"Zoe S Gan, Karthik Sundaram, Ariana L Smith","doi":"10.1097/JU.0000000000004455","DOIUrl":"10.1097/JU.0000000000004455","url":null,"abstract":"<p><strong>Purpose: </strong>Urinary incontinence (UI) is common in nulliparous female elite athletes, but underlying pathophysiology is inadequately understood. We examined urinary symptoms and associated pelvic floor anatomy and function in this population, hypothesizing that athletes with UI would exhibit pelvic floor findings seen in older incontinent women (eg, pelvic floor descent and urethral hypermobility) and findings attributable to elite sporting such as muscle hypertrophy.</p><p><strong>Materials and methods: </strong>We performed a cross-sectional study of National Collegiate Athletic Association Division 1 nulliparous female athletes comparing symptomatic (ie, currently or previously experienced urinary leakage during exercise) and asymptomatic athletes. We assessed demographics, sport characteristics, relevant medical history (including Brief Eating Disorder in Athletes Questionnaire) and validated genitourinary symptom questionnaires (Lower Urinary Tract Dysfunction Network Symptom Index-29 and Female Genitourinary Pain Index). Pelvic examination and dynamic MRI were used to assess the pelvic floor at rest and at maximal strain. Pelvic floor anatomic structures were evaluated and segmented by MRI.</p><p><strong>Results: </strong>Of 29 athletes (11 asymptomatic, 18 symptomatic), demographics, sport characteristics, and pelvic examination findings were not statistically different between groups. Symptomatic athletes had significantly worse urinary symptoms (median Lower Urinary Tract Dysfunction Network Symptom Index-29 8.5 vs 8.0, <i>P</i> = .022) and genitourinary pain (median Genitourinary Pain Index 7 vs 3, <i>P</i> = .036), greater anterior thickness of the striated urethral sphincter muscle (median 2.5 vs 1.8 mm, <i>P</i> = .016) and puborectalis and levator ani muscles (median 10.3 vs 8.6 mm, <i>P</i> = .028), and worse disordered eating (median Brief Eating Disorder in Athletes Questionnaire 7.5 vs 4.5, <i>P</i> = .022).</p><p><strong>Conclusions: </strong>In nulliparous female elite athletes with UI, dynamic pelvic MRI identified differences in pelvic floor anatomy, which may be part of a multifactorial etiology of UI.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"766-776"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143052980","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Urologic Oncology: Bladder, Penis, and Urethral Cancer, and Basic Principles of Oncology.","authors":"Sam S Chang","doi":"10.1097/JU.0000000000004389","DOIUrl":"10.1097/JU.0000000000004389","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"806-807"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143468408","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Juan Chipollini","doi":"10.1097/JU.0000000000004489","DOIUrl":"10.1097/JU.0000000000004489","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"749"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143625005","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Incidence of Erectile Dysfunction and Testosterone Deficiency in Testicular Cancer Survivors.","authors":"Kshitij Pandit, Kylie Morgan, Paul Riviere, Mai Dabbas, Margaret Meagher, Dhruv Puri, Brent Rose, Aditya Bagrodia","doi":"10.1097/JU.0000000000004461","DOIUrl":"10.1097/JU.0000000000004461","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"791"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143399444","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Editorial Comment.","authors":"Melinda Z Fu, Vignesh T Packiam","doi":"10.1097/JU.0000000000004482","DOIUrl":"10.1097/JU.0000000000004482","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"737-738"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"https://www.ncbi.nlm.nih.gov/pmc/articles/PMC12064354/pdf/","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143492601","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"OA","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Reply: Impact of Discordance Between Magnetic Resonance Imaging and Ultrasound Volume Measurements on Prostate Fusion Biopsy Outcomes.","authors":"Tabea Borde, Nicole Varble, Sandeep Gurram, Baris Turkbey, Peter Pinto, Brad Wood","doi":"10.1097/JU.0000000000004476","DOIUrl":"10.1097/JU.0000000000004476","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"796-798"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143501864","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Trauma, and Genital and Urethral Reconstruction.","authors":"Sean P Elliott","doi":"10.1097/JU.0000000000004419","DOIUrl":"10.1097/JU.0000000000004419","url":null,"abstract":"","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"808-810"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143573124","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Adjuvant Radiation Therapy or Observation With or Without Early Salvage Radiation Therapy for Men With Node-Positive Prostate Cancer After Surgery and Negative Preoperative Conventional Imaging: A Multicenter Study.","authors":"Giancarlo Marra, Francesco Barletta, Simone Scuderi, Gabriele Montefusco, Jonathan Olivier, Andres Affentranger, Josias Bastian Grogg, Thomas Hermanns, Luca Afferi, Christian Fankhauser, Agostino Mattei, Bartosz Malkiewicz, Alberto Bianchi, Alessandro Antonelli, Fabio Zattoni, Fabrizio Dal Moro, Lieke Wever, Timo F W Soeterik, Roderick C N Van Den Bergh, Pawel Rajwa, Shahrokh F Shariat, Rafael Sanchez-Salas, Lara Rodriguez-Sanchez, Rossella Nicoletti, Riccardo Campi, Mohamed Ahmed, R Jeffrey Karnes, Isabel Heidegger, Alberto Briganti, Francesco Montorsi, Paolo Gontero, Giorgio Gandaglia","doi":"10.1097/JU.0000000000004468","DOIUrl":"10.1097/JU.0000000000004468","url":null,"abstract":"<p><strong>Purpose: </strong>Our goals were to assess the survival outcomes of adjuvant radiation therapy (aRT) vs observation with or without early salvage radiation therapy for cN0M0 pN1 prostate cancer (PCa) and to create a model for clinical decision-making.</p><p><strong>Materials and methods: </strong>We retrospectively identified 1103 patients with cN0M0 PCa with pN1 PCa after surgery (2000-2021) at 18 referral centers. Kaplan-Meier curves and Cox proportional hazards models were used.</p><p><strong>Results: </strong>Overall, 670 patients (61%) had International Society of Urological Pathology (ISUP) 4 to 5, and the median number of positive nodes was 1. On multivariable analyses, ≥ 3 positive nodes (HR, 2.03, 95% CI, 1.22-3.37; <i>P</i> = .006) and ISUP 5 (HR, 1.92, 95% CI, 1.15-3.18; <i>P</i> = .01) were associated with an increased all-cause mortality. Based on pT stage, ISUP, and positive nodes, a 2 risk categories model was created. In men undergoing observation, 7-year disease-free survival was 27% (95% CI, 20.4-36) for low- to intermediate-risk and 11% (95% CI, 6.7-17) for high-risk patients; aRT had higher overall survival rates in the high-risk group (92%; 95% CI, 87-96 vs observation 84%, 95% CI, 77-90; <i>P</i> = .006). In interaction term analyses, aRT confirmed its protective effect on mortality in high-risk patients (HR, 0.28, 95% CI, 0.09-0.84, <i>P</i> = .024). Results were comparable when excluding men with PSA persistence.</p><p><strong>Conclusions: </strong>In cN0M0 pN+ PCa, aRT yields a survival benefit compared with observation with or without early salvage radiation therapy only in men with a high-risk disease based on unfavorable prognostic factors. We created a risk model to guide clinical decision-making in this setting.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"702-712"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391091","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}

{"title":"Gemcitabine vs Bacillus Calmette-Guérin for Intravesical Therapy in Treatment-Naïve Low-Grade Intermediate-Risk Nonmuscle-Invasive Bladder Cancer.","authors":"Zine-Eddine Khene, Raj Bhanvadia, Sarah Attia, Willian Ito, Ivan Trevino, Solomon L Woldu, Vitaly Margulis, Yair Lotan","doi":"10.1097/JU.0000000000004472","DOIUrl":"10.1097/JU.0000000000004472","url":null,"abstract":"<p><strong>Purpose: </strong>Patients with intermediate-risk (IR) nonmuscle-invasive bladder cancer (NMIBC) are recommended to receive induction intravesical chemotherapy or immunotherapy. However, the comparison between gemcitabine and bacillus Calmette-Guérin (BCG) in treatment-naïve patients with low-grade IR-NMIBC remains underexplored. The aim of this study was to evaluate the efficacy of gemcitabine compared with BCG in a cohort of treatment-naïve patients with IR-NMIBC.</p><p><strong>Materials and methods: </strong>A retrospective analysis was conducted on patients with low-grade IR-NMIBC, classified according to International Bladder Cancer Group criteria, with no history of induction intravesical treatment. Patients received either induction intravesical BCG or gemcitabine. Recurrence was defined as histologically confirmed cancer during follow-up, while progression included stage/grade progression. Kaplan-Meier estimates were used for survival analysis, and multivariable Cox analysis identified factors associated with recurrence and progression.</p><p><strong>Results: </strong>Of the 151 patients with IR-NMIBC, 78 received BCG and 73 received gemcitabine. Both groups completed the 6-week induction treatment at similar rates (100%), and maintenance therapy was administered to 47% of BCG-treated patients and 53% of gemcitabine-treated patients (<i>P</i> = .46). The median number of maintenance doses was 6 (IQR: 3-9) in the BCG group and 8 (IQR: 4-10) in the gemcitabine group (<i>P</i> = .83). Median follow-up was 54 months for patients receiving BCG and 36 months for patients receiving gemcitabine. After adjusting for age, International Bladder Cancer Group subgroups, year of treatment, single postoperative instillation, and maintenance therapy, gemcitabine was associated with a higher risk of recurrence compared with BCG (<i>P</i> = .02), while the risk of progression remained similar between the 2 groups (<i>P</i> = .87). Adverse events were observed in 62% of patients treated with BCG and 38% of patients treated with gemcitabine (<i>P</i> = .02).</p><p><strong>Conclusions: </strong>Gemcitabine is associated with a higher risk of recurrence than BCG in treatment-naïve patients with IR-NMIBC. However, both treatments show comparable efficacy in preventing disease progression.</p>","PeriodicalId":17471,"journal":{"name":"Journal of Urology","volume":" ","pages":"730-738"},"PeriodicalIF":5.9,"publicationDate":"2025-06-01","publicationTypes":"Journal Article","fieldsOfStudy":null,"isOpenAccess":false,"openAccessPdf":"","citationCount":null,"resultStr":null,"platform":"Semanticscholar","paperid":"143391092","PeriodicalName":null,"FirstCategoryId":null,"ListUrlMain":null,"RegionNum":2,"RegionCategory":"医学","ArticlePicture":[],"TitleCN":null,"AbstractTextCN":null,"PMCID":"","EPubDate":null,"PubModel":null,"JCR":null,"JCRName":null,"Score":null,"Total":0}